Prescribing guidance for excessive secretions

Noisy breathing is usually a result of excessive secretions and is an indicator of impending death. Noisy breathing occurs in about half of people who are actively dying. This symptom may be more distressing for the family and treating staff than for patients themselves.

1. Prescribe:
   • hyoscine BUTYLbromide - 20mg SC PRN every 2 to 4 hrs (PBS)
    
2. Administer if excessive respiratory secretions are present

Prescribing considerations

• Review patient regularly
• If greater than 3 doses of any PRN medicine are required over a 24 hour period, review and consider changes to medication and syringe driver orders
• Always check availability of medicines through the patient’s usual pharmacy

The medicines listed throughout this app are in line with those endorsed by Caring at Home and the Australian and New Zealand Society of Palliative Medicine (ANZSPM) within the Community End-of-Life Medicines List (168kb pdf).